Pregnancy: Having a Healthy Pregnancy
Your body will be constantly changing during pregnancy, which might cause some discomforts. Some discomforts might occur in the early weeks of pregnancy, while others will occur only as you get closer to delivery. Other discomforts might appear early and then go away, only to come back later. This is normal and usually does not mean something is wrong.
Some of the most common discomforts and ways to relieve them are described in this handout. Every woman’s pregnancy is unique, and some of these discomforts might not affect you. Discuss any concerns about your discomforts with your healthcare provider. Please refer to the “Medication Guidelines” section for over-the-counter medications to aid with discomforts of pregnancy.
Abdominal pain or discomfort
Sharp, shooting pains on either side of your stomach might result from the stretching tissue supporting your growing uterus. These pains might also travel down your thigh and into your leg.
Round ligament pain
Most common during the second trimester. Sharp pain in the abdomen or hip area that is either on one side or both, may extend to the groin area. Round ligament pain is considered a normal part of pregnancy.
The muscles in your uterus will contract (tighten) from about the fourth month of pregnancy. Irregular, infrequent contractions are called Braxton Hicks contractions.
- Try massage.
- Make sure you are getting enough fluids.
- Change your position or activity until you are comfortable. Avoid sharp turns or movements.
- If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue.
- Apply a hot water bottle or heating pad, or take a warm bath or shower.
Contact your healthcare provider if the pain is severe or constant, or if you are less than 36 weeks pregnant and you have signs of pre-term labor (listed below).
Signs of pre-term (premature) labor:
- More than 4 to 6 contractions (tightening of the muscles in the uterus, which cause discomfort or a dull ache in the lower abdomen) in an hour.
- Regular tightening or pain in your back or lower abdomen.
- Pressure in the pelvis or vagina.
- Menstrual-like cramps.
- Fluid leakage.
- Flu-like symptoms such as nausea, vomiting, and diarrhea.
Backaches are usually caused by the strain put on the back muscles, changing hormone levels, and changes in your posture.
- Wear low-heeled (but not flat) shoes.
- Avoid lifting heavy objects.
- Squat down with your knees bent when picking things up instead of bending down at the waist.
- Don't stand on your feet for long periods. If you need to stand for long periods, place one foot on a stool or box for support.
- Sit in a chair with good back support, or place a small pillow behind your lower back. Also place your feet on a footrest or stool.
- Sleep on your left or right side with a pillow between your legs for support.
- Apply a hot water bottle or heating pad, take a warm bath or shower, or try massage.
- Perform exercises, as advised by your healthcare provider, to make your back muscles stronger and help relieve the soreness.
- See a physical therapist or participate in a low back and pelvic pain shared medical appointment (SMA). Your provider can refer you.
- Maintain good posture. Standing up straight will ease the strain on your back.
- Contact your healthcare provider if you have a low backache that goes around your stomach and does not go away within 1 hour after you change position or rest. This might be a sign of premature labor.
Bleeding and swollen gums
The increase in your volume of circulation and supply of certain hormones might cause tenderness, swelling, and bleeding of gums.
- Take proper care of your teeth and gums. Brush and floss regularly.
- Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you have a problem.
Your breasts may increase in size as your milk glands enlarge and the fatty tissue increases. Your breasts are preparing to produce milk for your baby. Bluish veins might also appear as your blood supply increases. Your nipples will also darken and a thick fluid called colostrum might leak from your breasts. All of these breast changes are normal.
- Wear a supportive bra.
- Choose cotton bras or those made from other natural fibers.
- Increase your bra size as your breasts become larger. Your bra should fit well without irritating your nipples. Try maternity or nursing bras, which provide more support and can be used after pregnancy.
- Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. Nursing pads, which you can buy in a pharmacy, are another option.
- Clean your breasts with warm water only. Do not use soap or other products.
This is a great time to learn about the benefits of breastfeeding.
Your hormones, as well as vitamins and iron supplements, might cause constipation (difficulty passing stool or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus might also cause constipation.
- Add more fiber (such as whole grain foods, fresh fruits, and vegetables) to your diet.
- Drink plenty of fluids daily (at least 10 to 12 glasses of water and 1 to 2 glasses of fruit or prune juice).
- Drink warm liquids, especially in the morning.
- Exercise daily.
- Set a regular time for bowel movements; avoid straining when having a bowel movement.
Finding a comfortable resting position can become difficult later in pregnancy.
- Don't take sleep medication.
- Try drinking warm milk at bedtime.
- Try taking a warm shower or bath before bedtime.
- Use extra pillows for support while sleeping. Lying on your side, place a pillow under your head, abdomen, behind your back, and between your knees to prevent muscle strain and help you get the rest you need. You will probably feel better lying on your left side; this improves circulation of blood throughout your body.
- Move around often when standing for long periods of time.
- Turn on your side before rising from a lying down position.
- Try to move slowly when standing from a sitting position; avoid sudden movements.
Your growing baby requires extra energy, which might make you feel tired. Sometimes, feeling tired might be a sign of anemia (low iron in the blood), which is common during pregnancy.
- Get plenty of rest; go to bed early at night, and try taking naps during the day.
- Maintain a regular schedule, when possible, but pace your activities. Balance activity with rest when needed.
- Exercise daily to increase your energy level.
- If you think anemia might be a concern, ask your healthcare provider to test your blood.
During the first trimester, your growing uterus and growing baby press against your bladder, causing a frequent need to urinate. This will happen again when the baby's head drops into the pelvis before birth.
- Avoid tight-fitting underwear, pants, or pantyhose.
- Contact your healthcare provider if your urine burns or stings. This can be a sign of a urinary tract infection and should be treated right away.
How often headaches occur and how bad they are can vary.
- Apply an ice pack to your forehead or the back of your neck.
- Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to release the tension in your back, neck, and shoulders.
- Contact your healthcare provider if you have nausea with your headaches; if your headache is severe and does not go away; or if you have blurry vision, double vision, or blind spots.
Heartburn or Indigestion
Heartburn (indigestion) is a burning feeling that starts in the stomach and seems to rise to the throat. It occurs during pregnancy because your digestive system works more slowly due to changing hormone levels. Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward.
- Eat several small meals each day instead of 3 large meals.
- Eat slowly.
- Drink warm liquids such as herbal tea.
- Avoid fried, spicy, or rich foods, or any foods that seem to give you indigestion.
- Don't lie down directly after eating.
- Keep the head of your bed higher than the foot of your bed. Or, place pillows under your shoulders to prevent stomach acids from rising into your chest.
Hemorrhoids are swollen veins that appear as painful lumps on the anus. They might form as a result of increased circulation and pressure on the rectum and vagina from your growing baby.
- Try to avoid constipation. Constipation can cause hemorrhoids and will make them more painful.
- Try to avoid sitting or standing for long periods of time; change your position frequently.
- Make an effort not to strain during a bowel movement.
- Apply ice packs or cold compresses to the area, or take a warm tub bath a few times a day to provide relief.
- Avoid tight-fitting underwear, pants, or pantyhose.
- Discuss the use of a hemorrhoid treatment with your healthcare provider.
Pressure from your growing uterus can cause leg cramps or sharp pains down your legs.
- Be sure to eat and drink foods and beverages rich in calcium (such as milk, broccoli or cheese).
- Drink fluids with electrolytes, such as Powerade or Gatorade. However, be aware that these beverages are high in calories due to their sugar content.
- Wear comfortable, low-heeled shoes.
- Try wearing support hose but avoid any leg wear that is too tight.
- Elevate your legs when possible; avoid crossing your legs.
- Exercise daily.
- Stretch your legs before going to bed.
- Avoid lying on your back, since the weight of your body and the pressure of your enlarged uterus can slow the circulation in your legs, causing cramps.
- Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot, and pulling your toes toward you.
- Try massaging the cramp, or apply heat or a hot water bottle to sore area.
You might have a "stuffy nose" or feel like you have a cold. Pregnancy hormones sometimes dry out the lining in your nose, making it inflamed and swollen.
- Apply a warm, wet washcloth to your cheeks, eyes, and nose to reduce congestion.
- Don't use nose sprays; they can aggravate your symptoms.
- Drink plenty of fluids (at least 10 to 12 glasses of fluids a day) to thin mucus.
- Elevate your head with an extra pillow while sleeping to prevent mucus from blocking your throat.
- Use a humidifier or vaporizer to add moisture to the air.
Nausea or vomiting
Nausea can occur at any time of the day but might be worse in the morning when your stomach is empty (this is often called "morning sickness") or if you are not eating enough.
Nausea is a result of hormonal changes and most often occurs early in pregnancy until your body adjusts to the increased production of hormones.
- If nausea is a problem in the morning, eat dry foods like cereal, toast, or crackers before getting out of bed. Try eating a high-protein snack such as lean meat or cheese before going to bed. (Protein takes longer to digest.)
- Eat small meals or snacks every two to three hours rather than three large meals. Eat slowly and chew your food completely.
- Sip on fluids throughout the day. Avoid large amounts of fluids at one time. Try cool, clear fruit juices, such as apple or grape juice.
- Avoid spicy, fried, or greasy foods.
- If you are bothered by strong smells, eat foods cold or at room temperature, and avoid odors that bother you.
- Contact your healthcare provider if your vomiting is constant or so severe that you can't keep fluids or foods down. This can cause dehydration and should be treated right away.
Shortness of breath
You might feel short of breath when walking up stairs or walking briskly.
- Slow down and rest a few moments.
- Raise your arms over your head. This lifts your rib cage and allows you to breathe in more air.
- Avoid lying flat on your back, and try sleeping with your head elevated.
Stretch marks are a type of scar tissue that forms when the skin's normal elasticity is not enough for the stretching required during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks, or thighs. While they won't disappear completely, stretch marks will fade after your child's birth. Stretch marks affect the surface under the skin and are usually not preventable.
- Be sure that your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E).
- Apply lotion to your skin to keep it soft and reduce dryness.
- Exercise daily.
Swelling in the feet and legs
Pressure from the growing uterus on the blood vessels carrying blood from the lower body causes fluid retention which results in swelling (edema) in the legs and feet.
- Drink plenty of fluids (at least 10 to 12 glasses of fluids a day).
- Avoid foods high in salt (sodium).
- Elevate your legs and feet while sitting. Avoid crossing your legs.
- Wear loose, comfortable clothing. Tight clothing can slow circulation and increase fluid retention.
- Don't wear tight shoes; choose supportive shoes with low, wide heels.
- Keep your diet rich in protein. Too little protein can cause fluid retention.
- Notify your healthcare provider if your hands or face swell. This might be a warning sign of preeclampsia or toxemia, a pregnancy related high blood pressure.
- Rest on your side during the day to help increase blood flow to your kidneys.
Increased blood supply and hormones cause your vagina to increase normal secretions. Normal vaginal discharge is white or clear, non-irritating, and odorless, and might look yellow when dry on your underwear or pantiliners.
- Choose cotton underwear or brands made from other natural fibers.
- Avoid tight-fitting jeans or pants.
- Do not douche, because it is possible that you can introduce air into your circulatory system or break your bag of waters in later pregnancy.
- Clean the vaginal area often with soap and water.
- Wipe yourself from front to back.
- Contact your healthcare provider if you have burning, itching, irritation or swelling; bad odor; bloody discharge; or bright yellow or green discharge. These symptoms could be a sign of infection.
An increased volume of blood and the pressure of your growing uterus can slow your circulation, sometimes causing the veins in your legs to become larger or swollen.
Although varicose veins are usually hereditary, here are some preventive tips:
- Avoid standing or sitting in one place for long periods. It's important to get up and move around often.
- Avoid remaining in any position that might restrict the circulation in your legs (such as crossing your legs while sitting).
- Elevate your legs and feet while sitting.
- Exercise regularly.
- Wear support stockings but avoid any leg wear that is too tight; knee high or waist high is best. Avoid thigh-high legwear.